ABSTRACT
Background: IV drug abusers usually present with life threatening hemorrhage from ruptured infected femoral pseudoaneurysm in emergency. Back up of family, friends and resources are marginal with these patients. In literature many procedures from simple debridement to extra anatomic bypass have been reported
Objective: To assess the outcome of ligation of external iliac artery under local anesthesia in terms of survival, limb salvage and feasibility
Methodology: This cross sectional study was conducted in Department of Surgery, Quaid e Azam Medical College, Bahawalpur. Duration of study was five years from 1st December 2010 to 31st December 2015. All patients presenting with bleeding or ruptured femoral pseudoaneurysm in this time span were admitted. Pressure dressing over bleeding aneurysm was done; wide bore peripheral IV line/CV line was passed; fluid resuscitation was started; broad spectrum antibiotics were injected; request for blood arrangement sent and necessary investigations were sent; special consent was taken. Local Anesthesia was injected in the groin just above the aneurysm ketamine given their needed. External iliac artery was explored in supra inguinal position and ligated. Data regarding age, gender, drug of abuse, vascular status of the limb, need for blood transfusion during procedure, life safety, limb salvage was analyzed. Data was entered and analyzed by using SPSS version 20
Results: We ligated external iliac artery just proximal to aneurysm in 48 patients under local anesthesia. Life and limb was saved in 43 [89.5%] patients. Five patients [10.5%] required above knee amputation later
Conclusion: Ligation of external iliac artery under local anesthesia in ruptured pseudo aneurysms is simple and safe
ABSTRACT
Cilia are hair-like structures extending from the cell membrane, perform diverse biological functions. Primary defects in the structure and function of sensory and motile cilia result in multiple ciliopathies. The most prominent genetic abnormality involving motile cilia is primary ciliary dyskinesia [PCD] or Kartageners syndrome. PCD is a rare, usually autosomal recessive, genetically heterogeneous disorder characterized by sino-pulmonary disease, laterality defects and male infertility. One of the important components of cilia is the Dynein. Ciliary ultrastructural defects are identified in approximately 90% of PCD patients and involve the outer dynein arms, inner dynein arms, or both. Diagnosing PCD is challenging and requires a compatible clinical phenotype together with tests such as ciliary ultrastructural analysis, immunofluorescent staining, ciliary beat assessment, and/or nasal nitric oxide measurements. Increased understanding of the pathogenesis will aid in better diagnosis and treatment of PCD. The aim of the article is to present the basic defect involved in the etiology of this interesting syndrome